Health insurance is an essential aspect of one’s future as well as health planning. It is utterly beneficial in times of unanticipated sickness or accident, as it covers certain aspects related to the treatment of both. Furthermore, insurance provides tax benefits that make it a crucial aspect of one’s tax and financial planning.
Read the article to learn more about the new changes in health insurance like Star Health Insurance, and also answers to popular questions like ‘what to check before buying health insurance?’.
Overview
The table below summarises some key details about the new changes in health insurance.
| Changes introduced in | Health insurance provided by various institutions, like Care Health Insurance or HDFC ERGO Health Insurance |
|---|
| Made by | IRDAI |
| Changes concerning | Age, multiple claims, waiting period of pre-existing diseases, customised plans, etc. |
| Things to check before buying health insurance in India | Type of policy, coverage amount, waiting period, claim settlement, etc. |
Read More: Cashless Everywhere : Medical Bills For Health Insurance
What Are The Changes IRDAI Introduced Related To Health Insurance?
Recently, the Insurance Regulatory and Development Authority of India introduced changes in the existing rules and regulations related to health insurance, which all health insurance providers like Care Health Insurance or HDFC ERGO Health Insurance are supposed to follow. Let us have a look at them!
No Age Bar
Previously, there existed an age bar for new entrants or new buyers of health insurance policies. The age bar of 65 years has now been removed by IRDAI and the regulator has asked insurance companies to provide health insurance schemes for people of all age groups.
This is extremely beneficial for senior citizens who can now save money and access senior citizen healthcare insurance benefits without any age limit.
Waiting Period Of Pre- Existing Diseases
The waiting period of 4 years to seek mediclaim benefits as well as healthcare under health insurance has been ejected and the waiting period has been reduced to 3 years. This will facilitate access to treatment facilities for the elderly.
Most importantly, the reduction in the waiting period will prevent and prohibit insurance companies from refusing to pay PED claims after the 3 years waiting period.
Option To File Multiple Claims
The regulator has now allowed policyholders to file multiple claims with different insurers in case they hold multiple insurance policies. This would entitle the beneficiaries to choose from multiple options and seek the best option in case of diagnosis.
Indemnity Policies Done Away With
IRDAI has directed insurance companies to stop issuing indemnity-based policies and pay a fixed sum in events of covered disease diagnosis. The regulator has asked the companies to issue only ‘benefit’ based health insurance policies to its policyholders.
Moratorium Period
The Insurance regulator has reduced the moratorium period from 8 years to 5 years. This comes as a huge sigh of relief for policyholders since insurance providers will not be able to reject claims in case of non-disclosure of a pre-existing disease when there has been continuous coverage for 5 years.
However, an exception has been imposed in cases where claims constitute fraud.
Grievance Redressal Mechanism
The IRDAI has asked insurance companies to create proper mechanisms of claims and grievance redressal for the elderly. This is aimed at facilitating the process of making insurance claims and settling such grievances timely.
Customised Plans
The insurers have been directed by the regulator to formulate customised policies for children, maternity, undergoing subjects and the elderly. This way, the customers can choose from a variety of options and select the best health insurance policy for themselves.
No Sub-Limits On AYUSH Treatment
The sub-limits that were previously imposed on seeking AYUSH treatments have been lifted by IRDAI. Now, the policyholders will be able to extract claims up to the insured sum for seeking treatment under any AYUSH healthcare treatment.
Inclusivity By Issuing Policies To Severely Diseased
People with severe or extreme medical conditions will now be able to buy insurance plans for themselves with ease since IRDAI has now prohibited from refusing medical insurance policies to people with severe health conditions. This promotes inclusivity and equity amongst the masses.
Waiting Period For Specific Diseases
The waiting period for specific diseases has been reduced from 4 years to 3 years. Specific health conditions, such as those requiring orthopaedic treatment, will now be subject to claims after a waiting period of 3 years.
What To Check Before Buying Health Insurance?
Every individual should think of some questions to ask before buying health insurance. Those questions should be regarding the following points:
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Firstly, understand the various types of policies available and choose one based on your comfort.
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Ensure that the coverage amount under the health insurance policy is sufficient for you and your family.
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Verify the waiting period of pre-existing conditions, which has been reduced from 4 to 3 years by IRDAI.
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Please go through the inclusion and exclusion criteria carefully.
Conclusion
Health is a top priority for everyone. By introducing these changes in the health insurance sector, IRDAI has made the policies more pro-customers and inclusive in approach. These changes are expected to bring a positive change in the way both the stakeholder approach helps insurance, hence, be aware of these before buying health insurance.
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